Hospitals across sub-Saharan Africa are preparing for significant challenges as the supply of halothane, a key anesthetic widely used for pediatric surgeries, is expected to be exhausted by the end of 2027. Halothane’s last production facility, located in India, ceased operations in 2023, leaving medical facilities scrambling to identify alternative anesthetics and secure funding for costly equipment upgrades.

Halothane remains popular in many African health centers primarily due to its low cost, being seven to ten times cheaper than sevoflurane, the newer anesthetic alternative. However, while some high-end hospitals have already transitioned to sevoflurane, these facilities represent only a small fraction of healthcare settings in the region. The shift exposes longstanding underinvestment in anesthesia infrastructure, as many hospitals now face the need to replace outdated anesthesia machines that can cost tens of thousands of dollars.

Elizabeth Igaga, an anesthesiologist in Uganda and senior director for program safety at Smile Train—an organization performing over 100,000 cleft lip and palate surgeries annually, mostly on children—emphasized the gravity of the situation. “This halothane situation is a big deal for us. We are committed to them having safe surgery,” she said, underscoring the critical role halothane has played in pediatric surgical care.

The announcement of the halted halothane production sparked widespread concern across the region, with Zambia experiencing what Sompwe Mwansa, president of the country’s Society of Anesthetists, described as “nationwide panic.” Mwansa highlighted the difficulties in adapting to the new requirements, including catching up on equipment procurement and training personnel, particularly in healthcare centers outside urban areas. She noted that many anesthesia providers in Africa are not doctors and will require additional training to administer the new drugs effectively, a necessary step to prevent costly wastage.

Calls for urgent government action have been made by international bodies such as the World Federation of Societies of Anaesthesiologists, which in 2024 urged African nations to allocate budgets for the transition to alternative anesthetics. However, according to Smile Train, these appeals have not yet generated the timely response that the situation demands. Nevertheless, health authorities in Uganda and Zambia have reportedly taken positive steps to address the impending shortage.

This impending halothane shortage underscores broader challenges in healthcare financing and training across sub-Saharan Africa. Without adequate support and investment, the transition to more expensive anesthetics risks disrupting access to safe surgical care for thousands of children who depend on these procedures annually.